Organization
MARYLAND CVS PHARMACY, L.L.C.
Active
Other names
CVS PHARMACY # 03045
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR-PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
157 RITCHIE HIGHWAY, SEVERNA PARK, MD 21146-1130
(410) 421-5050
Mailing address
ONE CVS DRIVE, MAIL CODE 1090, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MD
333600000X
Pharmacy
Primary
—
MD
3336C0003X
Community/Retail Pharmacy
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1135775
—
MD
01
—
2140476
NCPDP
MD
01
—
3001491 00
DME
MD
Enumeration date
09/01/2016
Last updated
01/11/2017
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